History of infection control and its contributions to the development and success of brain tumor operations.

Before advancements in infection control, only conditions that brought patients near death warranted the risk of surgical intervention. If patients survived the operation, infection was nearly inevitable and death by overwhelming sepsis was knocking at their door. In the late 19th century, with the development of germ theory by Louis Pasteur and its subsequent application to surgical sterility by Joseph Lister, surgeons were able to operate with a substantially reduced risk of infection. Consequently, surgeons became more confident and began to explore more extravagant procedures, including elective operations within the cranial vault. As scientific knowledge expanded in the 20th century, so did the advancement of infection control with the use of prophylactic antibiotic drugs, heat sterilization of instruments, and microbial barriers. Recent reports have placed the rate of complications due to infection between 0.75 and 2.32% for intracranial operations.